P-13 Use of bone protection in patients with primary intracranial tumours on long term corticosteroids

Autor: Brennock, Jennifer, O’Leary, Norma, Hayden, Cliona
Zdroj: Supportive & Palliative Care; 20170101, Vol. 7 Issue: 0 pA5-A5, 1p
Abstrakt: BackgroundLong term use of corticosteroids can be associated with significant morbidity, including development of glucocorticoid-induced osteoporosis and resultant fractures, leading to increased pain and disability. There are currently no specific standards or guidelines pertaining to the use of bone protection in patients on long term corticosteroids in palliative care. However, given that a significant proportion of palliative care patients are on corticosteroids for prolonged periods, this is an area that should be explored further.AimsTo ascertain current use of bone protection in a palliative cohort of patients with a diagnosis of primary intracranial tumour on long term corticosteroid treatmentTo identify patients in this cohort who would likely have benefited from receiving bone protectionStandardsStandards used were the American College of Rheumatology 2010 Recommendations for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. These guidelines recommended for this cohort that patients on long term glucocorticoid treatment (dose ≥7.5 mg prednisolone daily for ≥ three months) should be on bone protection therapy (bisphosphonate).MethodologyRetrospective audit using chart review of patients with primary intracranial tumours on initial referral to Palliative Care Team.ResultsInitially 39 eligible patients identified. On manual review of these charts, 32 were eligible, n=32. 37.5% were on steroids on admission, and had been on steroids for > three months on initial assessment and had greater than three months to live. 12.5% had > six months to live and were on steroids on first assessment, and 6.25% had been on >3 month course of steroids.Conclusions62% patients who were initially assessed by palliative care team should have been considered for bone protection therapy prior to referral. 45% of patients were not suitable for consideration for bone protection treatment. This leaves 55% which could have potentially been considered for bone protection therapy by the palliative team following initial assessment.
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